1/25/2012
By: Carol Gentry
Health News Florida
After
blasting it as anti-consumer and anti-doctor, a House
justice panel nevertheless approved a PIP reform bill
today so that the effort to fight auto-accident fraud
wouldn’t die.
Members of the House Civil Justice Subcommittee voted
for
CS/HB 119
after its sponsor, Rep. Jim Boyd, assured them that he
would make major changes to the bill before it gets to
the floor.
The bill, which would create a whole new system for
auto-accident coverage, would require treatment to take
place within 72 hours and only in a hospital emergency
room -- a provision that even the bill's supporters
warned would overwhelm ERs and lead to unnecessary
costs.
Boyd, R-Bradenton, said his main concern is the
relentless rise in auto-insurance premiums to cover the
soaring cost of Personal Injury Protection coverage.
PIP, required for all drivers, covers up to $10,000 in
treatment after accidents, regardless of who is at
fault.
Boyd said PIP has led some unscrupulous lawyers and
clinics to stage accidents, fake injury claims and
charge for unnecessary scans and treatments. PIP
premiums have soared in Florida, state agencies are
reporting, and four Florida cities made a top-10 list
for stage accidents and insurance fraud put out by the
industry.
Members of the panel agreed with Boyd about the severity
of the problem.
“We are the only thing that stands between ...organized
crime and Florida policyholders,” said Rep. Bill Hager,
R-Boca Raton.
Last month, the state's Insurance Consumer Advocate
issued a report
that called PIP fraud in some areas of the state
"pervasive" and said it imposes a fraud tax on consumers
of nearly $1 billion a year.
With Boyd’s promise, Rep. Matt Gaetz, who had called
parts of the bill “indefensible,” agreed to withdraw two
major amendments.
One would have wiped out the section of the bill that
limits attorney’s fees in PIP cases for the driver, but
not for the insurance company. Several members of the
justice panel said they felt that was grossly unfair.
Gaetz also wants to kill the part of Boyd’s bill that
allows expanded “examinations under oath,” in
which insurance-company lawyers depose policyholders and
health-care providers at great length in a fashion that
Gaetz said could be threatening and intrusive.
A parade of attorneys from around the state, especially
the Orlando area, testified at the subcommittee hearing
that insurers are already using the depositions to
intimidate policyholders and those who provide treatment
into accepting lower payments than they are entitled to.
The bill would make it worse, they said.
The issue is extremely complex, filled with
mind-boggling jargon such as “contingency-risk
multipliers,” and pits the insurance industry against
the trial bar and some medical groups, especially those
who represent chiropractors, acupuncturists and massage
therapists.
The bill’s first stop was the House Insurance and
Banking Subcommittee, which substituted its own language
and
passed it
on Jan. 11. In addition to the Civil Justice
Subcommittee, it was assigned to Economic Affairs.
Senate leader Joe Negron has introduced a bill
that would allow patients to be treated either at
hospitals or doctor-owned clinics, but rules governing
the clinics would be tighter. Penalties for fraud would
be heavier.
Negron's bill would set new fee schedules on four types
of treatment that often lead to a court case.